I n t e r n a L medicine questions Bank

Answer: E (A wide variety of diseases are associated with splenomegaly, or enlargement of the
... Such as in subacute bacterial endocarditis or infectious mononucleosis ... http://emedicine.medscape.com/article/206208-overview)

19. 
    Classification of cardiomyopathy include all of the following, except:
    
    1. 
       Dilated cardiomyopath
       
    2. 
       Hypertrophic-IHSS
       
    3. 
       Restrictive cardiomyopathy
       
    4. 
       Arrythmogenic right ventricle
       
    5. 
       Prolpase mitral valve
       

19. 
    In pericarditis, all are true, except:
    

A. Chest pain increase by deep breating\
b. usually follow URI’\
C. on EKG, ST segment elevation is conve upwards\
D. pericardial rub can confirm diagnosis\
E. treated with NSIAD or aspirin
Answer: C (saddle shaped ST segment – convex downwards not upwards)

19. 
    All of the following are causes of secondary hypertension, except:
    

A. Coarcation of the aorta\
B. Renal artery stenosis\
C. Pheochromocytoma\
D. Female hormones nad NSAIDS\
E. Increase in arteriolar peripheral resisatnce
Drug-induced hypertension associated with NSAIDs is due to the renal effects of these drugs. Specifically, NSAIDs cause dose-related increases in sodium and water retention. This effect is also seen with COX-2 selective agents, such as celecoxib.[11]

a. ?

Inspiratory arm of the flow-volume loop wil be typically abnormal in which of the following conditions?
a. Bronchial asthma
b. Vocal cord dysfunction
c. Emphysema
d. Interstitial lung diseae
e. Bronchoiolitis obliterans



Vocal cord dysfunction involves inappropriate vocal cord motion that produces partial airway obstruction. Patients may present with respiratory distress that is often mistakenly diagnosed as asthma. Exercise, psychological conditions, airborne irritants, rhinosinusitis, gastroesophageal reflux disease, or use of certain medications may trigger vocal cord dysfunction. The differential diagnosis includes asthma, angioedema, vocal cord tumors, and vocal cord paralysis. Pulmonary function testing with a flow-volume loop and flexible laryngoscopy are valuable diagnostic tests for confirming vocal cord dysfunction. Treatment of acute episodes includes reassurance, breathing instruction, and use of a helium and oxygen mixture (heliox). Long-term management strategies include treatment for symptom triggers and speech therapy.


http://www.aafp.org/afp/2010/0115/p156.html

All of the following associations between conditions and mechanisms of hypoxia are true, except:

1. 
   COPD and V/Q mismatch (The principal contributor to hypoxemia in COPD patients is ventilation/perfusion (V/Q) mismatch resulting from progressive airflow limitation)
   
2. 
   ARDS and pulmonary shunt (edema in patients with ALI/ARDS is impaired gas exchange with intrapulmonary shunt,)
   
3. 
   Multiple rib fractures and hypoventilation
   
4. 
   Hepatopulmonary syndrome and V/Q mismatch (The hepatopulmonary syndrome is characterized by a defect in arterial oxygenation induced by pulmonary vascular dilatation in the setting of liver disease1) (Dyspnea and hypoxemia are worse in the upright position (which is called platypnea and orthodeoxia, respectively)
   
5. 
   Motor neuron disease and hypoventilation
   
19. 
    IN patients with sarcoidosis, all of the following are associated with good prognosis, except:
    

1. 
   Fever
   
2. 
   Erythema nodosum
   
3. 
   Age less than 40 years
   
4. 
   Black race
   
5. 
   Presence of polyarthritis
   

19. 
    Regarding the pathogenesis of bronchial asthma, one of the following is specific for the disease:
    

1. 
   Air flow limitation
   
2. 
   Airway hyper-responsiveness
   
3. 
   Inflammation of the mucosa
   
4. 
   Peak flow variability
   
5. 
   Brochioalevolar eosinophils
   

19. 
    The most common organism responsible for severe community pneumonia needing